Lancashire Safeguarding Adults Board Present LSAB Board Notes of meeting held 10 th February 2017 at Cabinet Room C, County Hall, Preston Zakeya Atcha Consultant in Public Health Medicine Lancashire County Council Kath Barron Area Operations Manager SA Lancashire County Council Randip Bhogal Area Operations Manager SA Lancashire County Council Jane Booth Independent Chair Lancashire Safeguarding Boards Tammy Bradley Operations Manager Progress Housing Group Peter Chapman Head of Safeguarding East Lancashire CCG Hayley Clarke Business Co-ordinator Lancashire Safeguarding Boards Tony Crook Service Group Manager Lancashire Fire & Rescue Service Vicki Evans Detective Chief Inspector Lancashire Constabulary Victoria Gibson Business Manager Lancashire Safeguarding Boards Jackie Gower Consultant Sion Hall Lancashire Constabulary Sarah Hargreaves Business Co-ordinator Lancashire Safeguarding Boards Mark Hammond MCA Professional Lancashire Crae Foundation Trust Glenn Harrison Patient Experience Manager NHS England Marie Hill Safeguarding Lead Cornmill Nursing Home/LCA Alice Marquis-Carr Head of Safeguarding Fylde & Wyre Clinical Yvette McGurn Principal Social Worker Lancashire County Council Danielle McMillian Business Co-ordinator Lancashire Safeguarding Boards Laura Nuttall Business Co-ordinator Lancashire Safeguarding Boards Sarah Raynor (Notes) Business Support Office Lancashire Sfaeguarding Boards Julie Seed Assistant Director Patient & SafGov Lancashire Teach Hosp NHS FT Kelly Short Lisa Slack Sheralee Turner- Birchall Margraret Williams Apologies Lead Nurse Adults Safeguarding and MCA DoLS Social Care/Safeguarding Lead for Specialist Services Chief Executive Chief Nurse Lancashire North Clinical Lancashire Care Foundation Trust Healthwatch Lancashire Lancashire North Clinical Lorriane Beavers County Councillor Council (FW) Lorraine Elliot Designated Lead Nurse for SA & MCA Greater Preston, Chorley &, West Lancs CCG Derek Harrison Governor Lancaster Farms Prison Sarah Jarvis Assistant Chief Officer National Probation Service
Jane Jones - 2 - Head of Safeguarding and Designated Nurse Safeguarding Children North Lancs Clinical Tony Pounder Director of Adult Services Lancashire County Council Bridgett Welch Associate Director of Nursing Lancashire Care Foundation Trust Louise Wilson Business Support Officer Lancashire Safeguarding Boards Louise Taylor Absent Corporate Director, Operations & Delivery Lancashire County Council Andrea Edmondson Safeguarding Practitioner North West Ambulance Service David Hayes Head Safe Prison & Equality HM Prison Service Cath Taylor Safeguarding Lead Merseycare Janet Thomas Deputy Director of Nursing Lancashire Care Foundation Trust No. ITEM ACTION 1. WELCOME AND APOLOGIES FOR ABSENCE JB welcomed all to the meeting and noted apologies as above. 2. NOTES OF MEETING HELD 4 th November 2016 - ACCURACY The notes were agreed as an accurate record subject to amendments to member's job titles which will be rectified. 3. REVIEW OF MATTERS ARISING AND/OR ACTION LOG The action log was reviewed and a number of updates reported. The log will be updated to reflect this. Additional points were raised as below: Zakyeya Atcha to be added to distribution list Ann Smith no longer part of Group- to be removed from distribuation List Action 70 - HC and KB to look into this action Action 89 - To be dicussed on agenda 10.02.17 Action 94 - to be dicussed on agenda 10.02.17 Actions 65, 66, 70, 71, 77, 78 and 80 Complete Action Log to be updated 4. MASH Update Jackie Gower was in attendance to give an update on MASH. JG informed the group that although the initial thinking was around the Children's MASH the same thinking can be applied to the Adults. JG shared a presentation with the group which is to be circulated with the notes. The following points were noted: A Number of revisions of the MASH processes have been undertaken over the last 18 months which non have concluded it is an effective service. Between October and December 2016 the key issues and actions of the MASH were agreed.
- 3 - Jan 2017- June 2017 first stage of implementation of actions agreed to improve the MASH. 4 key milestones have been identified. Designed principles agreed lead by police. Trafford have agreed a model for all age MASH. JG noted that this would be worth looking at. A number of task and finish groups and Steering groups are in place to review and redesign the MASH. Presentation to be circulated with the notes. 5. Draft Thresholds Guidance KB is now leading on this piece of work. Task and finish group working to strengthen the document is in place. A revised draft will be sent to VG by 20.02.2017 for circulation to Board members to comment. Some members raised concerns in relation to the title of the document. The content focuses on when to raise a safeguarding alert rather than setting thresholds. PC suggested to share the draft version of the document with Blackpool and Blackburn With Darwen as a suggestion of improving their practice. KB to send draft to MH to gain comments from the registered care network. VC to share with Blackpool and BwD to see if common approach can be established. Agenda item for next meeting KB VC LW 6. Lancashire North CCG Boundary Changes MW updated on the changes to the health footprint in Lancashire North, South Lakes and Barrow. Lancs North will open its boundaries to include South Lakes and Barrow which will double the population and increase the number of practices in the area from 12 to approximately 54. The CCGs will face cross boundary challenges due to reporting and joint working with 2 local authority's, 2 Healthwatch organisations, however GH confirmed that in terms of regional arrangements the current NHS England region will be known as NHS England Lancashire and South Cumbria covering the entire patch. The safeguarding team is in development and has been agreed as follows: Designated Doctor 3 Named GP Clinical Leads whose portfolio includes both Children and Adults (2 in post, looking for 3 rd ) 2 Band 7 Practitioners Shared roles with public health are also being explored around regulated care. Work is also being undertaken to consider integrated care communities. MW reported the new CCG area will be titled Morecambe Bay with South Cumbria and asked the board to be mindful of the wider footprint in policy development. Further updates will be provided when required MW
- 4-7. Lancashire Fire & Rescue and Mental Health TC raised the item as a learning point for information. A recent fatal fire identified some gaps in multi-agency working where Mental Health issues had not be raised with the fire service. TC wanted to reinforce the message to refer into the fire service. KB suggested a SAR maybe considered for this particular case if there is a multiagency failing. TC informed the group that NWAIS, Fire Service and Police have been asked to participate in a radio interview during BBC north west mental health awareness week. (Week commencing 13 th March 2017) PC to look into the details of the case to see if meets criteria for a SAR PC 8. Modern Slavery/human trafficking a) Duty to Notify - MH informed the group that although the duty to notify around Human Trafficking is not statutory to health bodies, LCFT have taken appropriate steps to ensure front line practitioners make voluntary notifications as a measure of good practice. A report detailing activity around this was circulated with the agenda, but some documents became inaccessible and therefore will be recirculated with the notes of the meeting. b) Police - Sion Hall provided an overview and update in relation to Human Trafficking activity. The following key points were noted: There are 3 main categories of exploitation linked to modern slavery - Sexual exploitation, Forced Labour and Domestic servitude. The latest statistics show that the Homeless are more vulnerable, and homeless centres are targeted. Increase of victims within East Lancashire and the Northwest due to cheap housing and unskilled work. Significate amount of victims will not admit they are victims, and are reluctant to come forward due to fear and mistrust in authorities. Organised Crime Groups are behind most of the trafficking of people into the UK. Police need to raise awareness of the issues so that people recognise the signs and report them. LCFT report included with agenda will be re-circulated in an accessible format. 9. Updates from sub groups a) Learning and Development Update of report was noted. No concerns raised b) Safeguarding Adult Leadership group Update of report was noted. No concerns raised. c) MCA DOLS
- 5 - Healthwatch are now a member of the group. Update of report was noted. No concerns raised. d) Practise with Providers The report was noted and following argreed: Guidance in relation to recruiting agency staff is agreed and will be published on the LSAB website; Update reports from other sub groups will not be shared, but more effective methods of communication will be identified. JB reported that quarterly news letters are in development which will assist with this. e) Quality assurance and audit TOR and membership will be discussed at next Audit sub group. Small task and finsh group to be developed in relation to Mental Capacity Act referal under age of 65. Date for Domestic violence audit has been exended. f) SAR Group 4 SAR's agreed. Still filtering them out and number of referrals are still High. It was agreed that SAR reports will be presented to Board memebers via extended Board meetings. 10. Performance Update a) Quarter 2 The data presented to Board relates to quarter 2. The subgroup meeting was too soon after the end of quarter 3 for the new data to be considered. The subgroup considered quarter 2 data and agreed on 7 areas of interest. The following points were discussed: The number of home fire safety checks has risen. The number of vulnerable adults missing from home has risen, with those flagged as missing accounting for 5.9% of vulnerable adults in the quarter. JB queried whether any further breakdown of those flagged as missing could be reported. HC to look into this. Police data in relation to numbers of crimes, victims and offenders showed that the number of victims is rising and number offenders falling. It was agreed that even though this was interesting information it does not relate purely to safeguarding and therefore should not be considered in the data set going forward. The data supports the fact that there is a large number of cases waiting in the DOLS waiting list. RB assured the group these cases will have been risk assessed and prioritised. However PC reported the delay in Blackburn is much lower than Lancashire and it was agreed that this needs to be looked into further by the MCA Group. Number of new referrals into MASH has decreased in quarter 2 by 5.5% compared to previous quarter. Whilst there has been reduction in this quarter there is a continued upward trajectory evident over time. Referrals into MASH which are mental health between ages of 60-65 continue to fall. Data provided by The Harbour suggests they have also experienced a reduction and commentary from LCFT suggest that the reduction in numbers maybe because referrals are being questioned prior to submission. The
- 6 - subgroup have decided to consider this via a Task and Finish group with possibility of dip sampling if appropriate. b) Audits Audit tool was shared with the agenda for information. Audit tool for Domestic Abuse has gone out to agencies. There is a 6 weeks turn around to complete the audits and return by the deadline of 10.03.17. This will allow time for findings to be collated ahead of the audit meetings scheduled for week commencing 24 April 2017. HC to advise the MCA Group of information found in data set in relation to large number of cases waiting; HC to look into whether a further breakdown of those flagged as missing could be reported. 11. Governance Document The group agreed to content of the document, but some further changes to membership will be addressed. VG to revise the membership VG 12. Any other business a) Joint Development Day VG reminded the group of the joint development day on the 20 March 2017 at Woodlands. Agenda is in preparation and will be circulated in advance. b) Presentation of SAR reports It was agreed that SAR reports will be discussed at the beginning or end of Board meetings. The next board date is 21 April 2017 and will be extended to approximately 2.30pm in order to receive presentation of a SAR report. 13. DATE OF NEXT MEETING 21 st April 2017 9:30am- 2:30pm Chorley House, Leyland HC HC